Impact of Obstructive Sleep Apnoea on Heart Failure with Preserved Ejection Fraction

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• 作者：Takuo Arikawa ; MD^a ; ^{takuoari@dokkyomed.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Shigeru Toyoda ; MD^a ; Akiko Haruyama ; MD^a ; Hirohisa Amano ; MD^a ; Shu Inami ; MD^a ; Naoyuki Otani ; MD^a ; Masashi Sakuma ; MD^a ; Isao Taguchi ; MD^b ; Shichiro Abe ; MD^a ; Koichi Node ; MD^c ; Teruo Inoue ; MD^a
• 关键词：Obstructive sleep apnoea ; Heart failure with preserved ejection fraction ; Left ventricular diastolic function ; Brain natriuretic peptide ; Long-term prognosis
• 刊名：Heart, Lung and Circulation
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：25
• 期：5
• 页码：435-441
• 全文大小：393 K

文摘

The impact of obstructive sleep apnoea on heart failure with preserved ejection fraction is unknown.

Methods

Fifty-eight patients who had heart failure with a left ventricular ejection fraction; ≥50% underwent a sleep study. Brain natriuretic peptide (BNP) levels were determined at enrolment and at one, six, 12 and 36 months after enrolment.

Results

Obstructive sleep apnoea was found in 39 patients (67%), and they were all subsequently treated with continuous positive airway pressure. Echocardiography at admission showed that E/E’ tended to be higher in the 39 patients with, than in the 19 patients without, obstructive sleep apnoea (15.0±3.6 vs 12.1±1.9, respectively, P=0.05). The median BNP levels at enrolment were similar in patients with and without obstructive sleep apnoea [median (interquartile range): 444 (233-752) vs 316 (218-703) pg/ml]. Although BNP levels decreased over time in both groups, the reduction was less pronounced in patients with obstructive sleep apnoea (P<0.05). Consequently, BNP levels were higher in patients with sleep apnoea at six months, [221 (137-324) vs 76 (38-96) pg/ml, P<0.05], 12 months [123 (98-197) vs 52 (38-76) pg/ml, P<0.05] and 36 months [115 (64-174) vs 56 (25-74) pg/ml, P<0.05].

Conclusion

Obstructive sleep apnoea, even when treated appropriately, may worsen long-term cardiac function and outcomes in patients who have heart failure with preserved ejection fraction.